Nephrology Unit, University Hospital, Parma, Italy.
Renal Pathology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Curr Rheumatol Rep. 2021 Feb 10;23(3):18. doi: 10.1007/s11926-020-00966-9.
We aim to review the most relevant diagnostic features and treatment options of retroperitoneal fibrosis, in order to provide a useful guide for clinical practice.
The recent literature highlights the role of imaging studies such as computed tomography, magnetic resonance imaging and positron emission tomography as useful tools for the diagnosis of retroperitoneal fibrosis, with retroperitoneal biopsy being reserved to atypical cases. The treatment approach is mainly conservative and is based on the use of medical therapies plus urological interventions. Medical therapies essentially comprise glucocorticoids and immunosuppressants-either traditional or biological agents such as rituximab. Surgical ureterolysis is only left for refractory cases. Recent findings in retroperitoneal fibrosis highlight the possibility of a non-invasive diagnostic approach and a conservative treatment strategy.
本文旨在回顾腹膜后纤维化的最相关诊断特征和治疗选择，为临床实践提供有用的指导。
最近的文献强调了影像学检查（如计算机断层扫描、磁共振成像和正电子发射断层扫描）在腹膜后纤维化诊断中的作用，腹膜后活检仅保留用于非典型病例。治疗方法主要是保守的，基于使用药物治疗加泌尿外科干预。药物治疗主要包括糖皮质激素和免疫抑制剂——传统或生物制剂，如利妥昔单抗。只有在难治性病例中才会采用外科输尿管松解术。腹膜后纤维化的最新发现强调了非侵入性诊断方法和保守治疗策略的可能性。
